Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists. A place to talk; no one has to listen.
All patient vignettes are confabulated; the psychiatrists, however, are mostly real.
--Topics include psychotherapy, humor, depression, bipolar, anxiety, schizophrenia, medications, ethics, psychopharmacology, forensic and correctional psychiatry, psychology, mental health, chocolate, and emotional support ducks. Don't ask. (It's not Shrink Wrap.)

Wednesday, September 26, 2012

Jesse was reading my novel, Home Inspection, a story told through the psychotherapy of two patients."I was reading the chapter where Tom talks about decorating his new home, and I thought, 'No patient has ever talked to me in that kind of detail about such things.' " Really? People tell me stories in a lot of detail, at least some do. I started to think about it, do people talk to me in that detail. Maybe not. Then my next two patients came in. One talked about a favorite food that was on special at a grocery store and how they only stock it for certain seasons. The next talked about the seating arrangements (chair by chair) for a party she is organizing. Yes, people talk to me in that kind of detail.It left Jesse and I to wonder if there is some difference about our styles that people talk to us about a different degree of detail, or if people talk to female psychiatrists about different things than they talk to male psychiatrists about. What do you think?

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comments:

Good one. My psychotherapist is male, my psychiatrist is female. In general I choose male Dr.s I have no idea why. But my psych came highly recommended and I get along really well with her.

I will talk in great detail to both of them, but it is generally about different things. I may open up to the therapist about subject "A" but not gutsy enough to tell the psych about subject "A." I think it is a mix of knowing what questions to ask, what kind of relationship you have with your Dr./ therapist and yes, gender may have a small role in the scheme of it.

I am also a talker, so if I have a good audience, I will talk more than usual.

It's funny that you mention that...because when I was reading Home Inspection I remember thinking to myself, Do her patients really talk like this? They did kinda go on and on sometimes with long descriptive, narratives that could be so flowery and poetic at times that I wondered if maybe you were exaggerating for effect. I don't remember exactly what parts, but there were times when I thought that there was no way her patients actually talk like this in therapy. I can give some pretty long-winded monologues, but I don't remember talking like that in therapy.

Is it cuz your a girl? Who knows! Does gender matter anymore? Jesse posted a video with the song Dancing Queen attached to it, and that's not exactly a hyper masculine song. If I ever meet Jesse in real life and start talking to him like a girlfriend and going into all kinds of details about decorating my kitchen with eggplant colored paint and seating arrangements then I will let you know...Maybe make your office super masculine and see what happens. You guys should try that. Jesse should put ABBA posters in his office and start acting really flamboyant. Then you should dress really butch and make a manly office with a dead animal head on the wall and see if your patients talk to you both differently.

I don't know, Dinah. You type phrases like, "Oh my" so sometimes you sound kind of like a Southern belle. I used to think you were from Alabama. Maybe that's what's getting people to share all kinds of details with you. Maybe they think Gone With The Wind when they meet you? You even have a Gone With The Wind sounding first name. Southern belles are famous for being the ultimate, polite hostesses, who make lots of chit chat and gossip about every last detail regardless of how boring it is. Oh my gosh! You even think of yourself as a hostess!!! I just realized that. Your always saying how your website is your living room, so it's like your hosting guests. Are you acting like a polite hostess when your patients enter your office, so it makes them feel like it's time for small talk?

Maybe start behaving a little more Scarlett O'Hara? Who wants to gossip with Scarlett? She's a get to the point kind of gal.

Dinah had asked me to blog about our discussion but I got sidetracked with other things (not necessarily more important things). So, after our discussion I paid more attention to the way my patients talk. I suspect that different therapists unconsciously encourage more of one type of communication than others do. How could that not be true? And I wondered if the gender of the therapist would lead a patient to assume a greater interest in certain details.

Jane, that video was made by my son, Ed. The chinchilla is Chinstrap. A really sweet little fellow who died three years ago.

Personally I wouldn't speak to the male about decorating or planning a party. I would think a woman doctor would be easier to relate with and understand my thoughts and perspectives better being that I am a woman. Speaking with a male I would be more hesitant to say things that I personally dont think he could relate to (girl things like party planning, shopping etc). Also, I would hope that I would be only talking about serious issues with a doctor though.

Very often even the most prosaic communication, sounding trivial on the surface, is a link to more important issues. A good therapist listens to what is below the surface and helps a patient talk about it..

I typically only go into extreme detail when I'm trying to avoid talking about something else. Are you sure your clients aren't hiding something beneath the long-winded descriptions?

There are some things I found that I was more comfortable opening up to a female about than a male. I think that's only natural, there's just some things that don't transfer between genders very well. However, my moments of extreme detail happened with both genders and only when I felt I could get away with covering up the real issue by carrying on for long enough to divert the therapist from asking what I wasn't comfortable really talking about.

I find that I talk about what I think the therapist can hear on top of my own issue of getting sidelines by trivial stuff as a way to avoid anything important. I have a hard time when the therapist not only sits and listens to trivial stuff but then starts to respond like we are having girlfriend talk about things that you don't need a therapist for. Jane, I take it you are youngish. A lot of older women (fiftyish or more)say oh my. I have no clue why. I stick with wtf and I can't see becoming an oh myer.

I liked that WTF from her. There's that attitude I was talking about! Something a little more aggressive than oh my should keep the patients focused and ready to talk about real issues and not party planning.

At least she sounds polite and sophisticated. She's doing New Jersey a favor. That state's image was nearly destroyed by Jersey Shore...

Personally, it doesn't make a difference to me. I've seen female therapists in the past and my current psychiatrist is male and also does my therapy. To me, what is important is the connection I have with the person. Do I feel comfortable enough to let my guard down with this person? Do I trust that they have my best interests at heart? Do I feel they care about me as a person and not just another patient on a conveyor belt through their office. I can answer yes to all those questions with my current shrink, which is why I like him so much and you couldn't pay me to switch to another.

I don't know if I talk differently to my male vs. female psychiatrists--probably. What I do know is that it gives me a really good feeling sometimes to be able to talk about mundane things with my therapist. I just love the luxury of basking in their listening and feeling safe in secure and happy enough to talk about seemingly trivial things. I don't know why but I find it comforting.

P.S. Seems like there is some real harshness toward comments about Dinah and I object to some of the comments. --Not that Dinah can't stand up for herself.

I think that it depends on the person. Some people need to talk about dinner parties, decorating and minor details. I am someone who is into the minutia, and that is what makes me very good at my job. I talk to my therapist about the little details because I see more meaning in those details then I do in the big picture, he is the person who draws me back to the big picture as part of my therapy.

I have also talked to my therapist about decorating, because decorating my house was part of a breakthrough. Making the place where I had lived for a few years a home for me, not waiting for someone to move in, so we could decorate it together. It was also a breakthrough because for the first time in years I changed my bedroom from red, browns and tans (think dark, passionate, sexy) to calming blues with white billowing curtains. My bedroom changed from being a place where I brought men and hoped to keep them in my life to being a place for me, a calm serene place.

Certain therapist might draw out certain things, but clients need to discuss different things in different ways.

I talk about most things--trivial or important--in copious detail, so the therapist's gender doesn't really impact how I communicate. However--and I'm speaking in generalities--I do think females are more comfortable and attuned to this kind of style, so perhaps female therapists do encourage it more. Some people are blessed with a talent for succinctly communicating all the important stuff; others ramble on forever to say the same thing. But lots of detail can be good! How many times has your perception of something changed once you knew more? And when we don't have details and we're left to fill in the blanks... well, isn't that what transference is about? I'm referring to the everyday, garden variety of transference inherent in human interactions: we make assumptions based on our own experiences and understanding of things. I was kind of surprised and amused by how mundane much of what Tom and Polly talked about in therapy seemed. These characters were far more attractive, intelligent, accomplished and worldly than I am, and yet their sessions often didn't sound all that different than my own. They'd also experienced trauma and dysfunctional parental relationships which should have made them interesting, but the depth and vibrancy wasn't there for me. I did find your protagonist more engaging and accessible, Dinah.

I disagree. Depending on your issues the sex of the therapist can make a huge deal. For the first time I have a male therapist and it was a big struggle for me to trust him. (my issues). I thoughed it out and it helped me tremendously in relating to my husband. The therapeutic relationship and my learning to trust a man with my emotions was a new and healing experience. I have had wonderful female therapists, but this was a different experience.